Field Instructor Confirmation of Internship Arrangements for 2nd Year Placement
To: Susan Elswick EdD, LMSW, LSSW
Director of MSW Field Placement
Department of Social Work
Re: Field Placement Intern
From: ___________________________
Agency: _________________________
I have met with _____________________ to confirm her/him engaging in field placement at this
agency for the next academic year. We have discussed the placement and everything that the
student will need to do in order to be ready to start placement as soon as school begins in the fall.
We have mutually agreed that the student is to begin the placement as of the following date and
time: ___________________________, and that her/his field instructor will be
______________________________. I have instructed the student to report to the office located
at _____________________________ on the first day of placement.
In order that there will be no delay in the student starting on that date, s/he must take care of the
following matters beforehand (e.g. background check, physical exam and/or TB test, orientation,
etc):
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
_________________________________
(Signature)
___________________
(Date)
Please return this notice to the Director of Graduate Field Placement
selswick@memphis.edu
or
By fax at: 678-2981, or
By mail at: The University of Memphis, 226 McCord Hall, Memphis, TN 38152